Liverpool Cancer Psychology

The Liverpool Cancer Psychology Service offers psychological support to individuals aged 25 and over, who have a Liverpool GP or ongoing cancer care under a consultant at Liverpool University Hospitals, whose psychological distress relates specifically to their cancer diagnosis and has a significant impact upon their daily life. The service is not able to provide a crisis or emergency service.

Referrals are accepted from professionals involved in the individual’s care, such as their cancer nurse specialist (CNS). We also recommend that it is important for a natural adjustment period of approximately eight weeks to take place following diagnosis or any significant news regarding cancer before formal psychological support is considered, to allow time to make sense of thoughts and feelings and draw upon existing support networks or coping strategies. The resources on our service page may be helpful to use during this time.

Full referral criteria for the service is available to download and read.

Appointments may be offered face-to-face, by video or by telephone as per your preference. All you may discuss in your appointments is confidential. In case of risk of harm to you or others we would need to discuss this with other professionals, however, we would always let you know first. This is to protect your safety and safety of others. For further information, please see the Trust’s Privacy Policy.

• Face to face appointments are usually carried out in Outpatients 1 and Outpatients 2 consultation rooms, Ground Floor, Royal Liverpool University Hospital
• Assessment appointments usually last 75 minutes
• Therapy and review appointments normally last 60 minutes
• During your initial appointment, we aim to understand your difficulties and consider if further sessions with a psychologist will be useful for you. Sometimes it can take more than one session to reach a decision about this.
• For some people, a one-off psychology assessment is enough for them (and their medical team) to understand and cope better with their needs. For others multiple sessions are needed.
• For those facing more complex issues, a longer course of therapy can be helpful.
• People who need a longer course of therapy may need to wait a few months for this depending on our waiting list at the time. Where necessary, we can offer telephone reviews during this period. We can offer therapy more quickly if there is an urgent clinical need.
• If English is not your first language, we can offer you an interpreter. Visit the interpreter services page for more information.

We can draw on a range of psychological approaches which are best suited to meet your specific needs. These can include:

Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy (ACT) encourages us to get in touch with what really matters to us and use these values to guide and motivate us. It teaches us how to embrace our thoughts and feelings instead of trying to get rid of them and getting frustrated with ourselves.

One technique in ACT that you may have heard of is “mindfulness.” But what really is mindfulness?! Mindfulness aims to connect us with the present moment. Concentrating on the present moment can be hard as our minds are busy thinking, problem solving, analysing…which is usually OK! But sometimes our minds get stuck on a problem that cannot be solved or play an upsetting moment over and over again. This can leave us feeling worried, upset, and stressed.

Mindfulness offers us another option to this usual way of thinking. It simply teaches us skills to focus on the present moment, without getting tangled up in difficult thoughts or emotions. Studies all over the world have shown how helpful mindfulness is to our mental and physical health. We have placed mindfulness exercises for you to try in “useful infomation.”

Cognitive Behavioural Therapy (CBT)

CBT is a widely supported psychological therapy and is the recommended approach across many mental health problems.

With CBT we can better understand how we think (thoughts), how we feel (emotions) and how we act (behaviour) all link together.

Therefore, if we experience negative thoughts, we can experience distress, low mood, anxiety, and it can impact what we do.

By becoming aware of how we interpret our thoughts, feelings, and behaviour we can learn new ways of coping. Usually, we start CBT by exploring what problems you want to work on and what your goals for therapy are. We then work together using weekly therapy sessions and between-session tasks to try and achieve your goals.

Metacognitive Therapy (MCT)

MCT is a psychological therapy which focusses on helping people to modify unhelpful beliefs about worry. The therapy aims to help people discover new, and more helpful ways to react to distressing thoughts, so it is less likely that you will spend time dwelling/ruminating on these and learn to develop more helpful ways of managing when distressing thoughts occur.

Mindfulness Based Cognitive Therapy (MBCT)

• MBCT is a course of eight weekly sessions, and a programme of practices to do at home. It teaches us ways to respond to our troubles more skilfully, and to experience happier moments more fully. This course offers a chance to move away from being on “automatic pilot” and to understand how our thinking can influence our physical and emotional experiences.
• Mindfulness can be helpful for everyone in coping with the large and small stresses and struggles of everyday life. Mindfulness-based approaches have been shown to help people cope better with cancer and other health conditions, and to be less caught up in worries.

Motivational Interviewing (MI)

• Motivational interviewing is an approach that helps people to adapt and develop their own potential to cope with life situations to lead a balanced life.
• This is by working in partnership with the psychologist to make decisions based on what is important for you.

Compassion Focused Therapy (CFT)

CFT focuses on understanding how the experience of ‘threat’, or danger (including serious illness, disability, changes to our identity) affect us in really understandable ways, leaving us in ‘fight’ or ‘flight’ mode. Being in this 'threat mode' can effect the way we react to others and the way we care for ourselves.

CFT is often used when people experienced high levels of guilt, shame, or feelings of loss and grief. In CFT your therapists will talk to you about how this threat state is both useful but can overshadow other ways of being, and how to best build up alternative skills to manage threat in a more helpful way. This can include developing our compassionate and soothing system to reduce distress.

CFT often addresses how criticism (from others or from the self) can increase anxiety, lower mood and motivation, and can teach skills in using compassion as an alternative to criticism.

Your therapist will work with you to find imagery, meditation and other techniques that are uniquely helpful for you in your current situation.

Eye Movement Desensitization and Reprocessing (EMDR)

Eye Movement Desensitization and Reprocessing (EMDR) is a therapeutic approach developed by Francine Shapiro in 1987 to help individuals process traumatic memories and experiences.

EMDR leverages the brain's natural healing mechanisms, particularly those active during rapid eye movement (REM) sleep, to promote recovery. When trauma or prolonged stress overwhelms the brain’s usual coping systems, distressing memories can become "stuck" in a heightened emotional state, leading to flashbacks, nightmares, intrusive thoughts, and intense emotional reactions.

During an EMDR session, individuals are guided through a series of eye movements or other forms of bilateral stimulation (such as tapping) while recalling a troubling memory. This process helps connect the brain's memory networks, allowing these memories to become "unstuck" and transformed into less emotionally charged recollections. Clients remain fully in control, alert, and can stop or pause the session at any time.

Initially developed for trauma treatment, EMDR is endorsed by organizations such as the National Institute for Health and Care Excellence (NICE) and the World Health Organization (WHO). It can also help individuals manage the emotional impact of stressful medical conditions, like a cancer diagnosis, by supporting the processing of related fears and emotional distress.

• The Cancer Psychology Service runs a sleep group for patients and/or families who find that a cancer diagnosis/treatment are causing them sleeping difficulties which is affecting their functioning
• The group is available for patients on the therapy waiting list for the service or patients can be referred by Cancer Nurse Specialists and Macmillan at the Royal and Aintree
• The group provides information on managing sleep from sleep hygiene to managing worry with relaxation and mindfulness practices
• The group runs over three weeks, one session a week (available in F2F or online) a few times a year
• A member of the team will contact you to discuss your interest and suitability for attending the group.

Getting Involved is a group of people who have used our service, are carers or loved ones of people who have used our service, and others who are interested. The aim of the group is to support clinicians and researchers to ensure that the patient perspective is fully taken into account.

What is involved?

The Getting Involved group means providing your views and feedback about a range of service related and research projects. We will share a newsletter with updates from the service and projects to get involved with. There will also be opportunities for members to meet and discuss feedback and ideas on how to improve the service.

Opportunities may include:

• Making changes to the way services communicate
• Making changes to the services provide
• Helping to ensure that research is patient and carer focused
• Being involved in the management of research studies
• Being a participant in a research study at the University of Liverpool.

If you are interested in learning more or would like to get involved, please take our quick survey.

“Opportunity to talk about trauma that I could not with family and friends. A non judgemental and not worrying about upsetting family.”

“My anxiety as a cancer patient was acknowledged from the start of all the sessions. We had very open and frank conversations about dealing with anxieties, and in each session, I developed strategies to deal with cancer-associated problems. I found all the sessions really helpful and self-liberating. Thank you!"

“I felt really listened to and understood and received some good advice re- my operation concerns and anxiety.”

• LUHFT Clinical Health Psychology - YouTube
• Maggie's Wirral | Maggie's (maggies.org)
• Macmillan Cancer Support | The UK's leading cancer care charity (Macmillan information centres are available in all of our hospitals)
• Welfare rights advice | Macmillan Cancer Support
• Benefits and work | Maggie's (maggies.org)
• Talk Liverpool
• Home - Liverpool Sunflowers
• Information and support - Mind.